Einhorn, L., H., Grunberg, S., M., Rapoport, B., Rittenberg, C., & Feyer, P. (2011). Antiemetic therapy for multiple-day chemotherapy and additional topics consisting of rescue antiemetics and high-dose chemotherapy with stem cell transplant: Review and consensus statement. Supportive Care in Cancer, 19, S1-S4.

To evaluate topics related to nausea and vomiting, specifically antiemetic therapy in high-dose chemotherapy with stem cell transplant and the use of rescue antiemetic for refractory emesis, with the intention of developing a consensus statement

Recommendations were rated using the Multinational Association of Supportive Care in Cancer (MASCC) and European Society for Medical Oncology (ESMO) levels of confidence for evidence strength rating.

Patients were in active treatment.

Patients receiving multiple-day cisplatin should receive a 5-HT₃ receptor antagonist plus dexamethasone for acute nausea and vomiting and dexamethasone for delayed nausea and vomiting. Because emesis in progress is difficult to control, include maximally effective antiemetics in first-line prophylactic antiemetic regimens so that rescue therapy will not be necessary. No clear evidence was provided on the most effective management of breakthrough or refractory CINV, and it is recommended that maximal prophylactic antiemetics are the best current approach.

The authors concluded that control of nausea and vomiting with high-dose chemotherapy remains a problem and more evidence is needed to aid researchers in making guideline decisions as to how to best manage CINV using modern antiemetics. Limited evidence is available for management of breakthrough and refractory CINV.